PDF File
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Eff. Date: 02/07/2023
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ACCOLATE, ZAFIRLUKAST |
224 KB |
PDF File
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Eff. Date: 10/27/2023
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ADDERALL, AMPHETAMINE, AMPHETAMINE ER, AMPHETAMINE/DEXTROAMPHET SALTS, AZSTARYS, ADZENYS, ADZENYS-ODT, AMPHETAMINE/DEXTROAMPHET SALTS ER, ADHASIA XR, APTENSIO XR, CLONIDINE, CONCERTA ER, COTEMPLA, DAYTRANA, DESOXYN, DEXMETHYLPHENIDATE, DEXEDRINE, DEXMETHYLPHENIDATE, DYANAVEL, EVEKEO, FOCALIN XR, FOCALIN, GUANFACINE, INTUNIV, JORNAY, METHAMPHETAMINE, METHYLIN, METHYLPHENIDATE, METHYLPHENIDATE ER, METHYLPHENIDATE CD, MYDAYIS, PROCENTRA, QELBREE, QUILLICHEW, QUILLIVANT, RITALIN, STRATTERA, VYVANSE, ZENZEDI |
847 KB |
PDF File
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Eff. Date: 12/01/2022
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CERDELGA, CEREZYME, ELELYSO, MIGLUSTAT, VPRIV, ZAVESCA |
833 KB |
PDF File
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Eff. Date: 07/05/2022
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ALISKIREN, TEKTURNA |
2 MB |
PDF File
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Eff. Date: 09/20/2023
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GRASTEK, ORALAIR, PALFORZIA, RAGWITEK |
1 MB |
PDF File
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Eff. Date: 10/18/2022
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GOCOVRI ER, OSMOLEX ER |
610 KB |
PDF File
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Eff. Date: 12/20/2022
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ANDRODERM, ANDROGEL 1%, ANDROGEL 1.62%, FORTESTA, JATENZO, KYZATREX, NATESTO NASAL, TESTIM, TESTOSTERONE, TLANDO, VOGELXO |
741 KB |
PDF File
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Eff. Date: 07/05/2022
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AKYNZEO, APREPITANT, EMEND, GRANISETRON HCL, SANCUSO |
717 KB |
PDF File
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Eff. Date: 12/01/2023
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ABILIFY, ABILIFY ASIMTUFII, ABILIFY DISCMELT, ABILIFY MAINTENA, ABILIFY MYCITE, AMITRIPTYLINE/PERPHENAZINE, ASENAPINE, ARIPIPRAZOLE, ARISTADA ER, CAPLYTA, CHLORPROMAZINE, CLOZAPINE, CLOZAPINE ODT, CLOZARIL, FANAPT, FAZACLO, FLUPHENAZINE, GEODON, HALDOL DECANOATE, HALOPERIDOL, INVEGA ER, INVEGA HAFYERA, INVEGA SUSTENNA, INVEGA TRINZA, LATUDA, LOXAPINE, LYBALVI, MOLINDONE HCL, OLANZAPINE, OLANZAPINE ODT, OLANZAPINE/FLUOXETINE, ORAP, PALIPERIDONE ER, PERPHENAZINE, PERSERIS ER, PIMOZIDE, QUETIAPINE , REXULTI, RISPERDAL , RISPERDAL CONSTA, RISPERDAL M-TAB, RISPERIDONE, SAPHRIS, SECUADO, SEROQUEL, SYMBYAX, THIORIDAZINE, THIOTHIXENE, TRIFLUOPERAZINE, UZEDY ER, VERSACLOZ, VRAYLAR, ZIPRASIDONE, ZYPREXA, ZYPREXA RELPREVV, ZYPREXA ZYDIS |
375 KB |
PDF File
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Eff. Date: 02/08/2023
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EPIDIOLEX, FINTEPLA, DIACOMIT |
834 KB |
PDF File
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Eff. Date: 10/12/2023
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ALPRAZOLAM, XANAX, CHLORDIAZEPOXIDE, MEPROBAMATE, OXAZEPAM, DIAZEPAM, CLONAZEPAM, KLONOPIN, CLORAZEPATE, TRANXENE T, LORAZEPAM, TEMAZEPAM, TRIAZOLAM, ZOLPIDEM, ESTAZOLAM, RESTORIL, TEMAZEPAM, ESZOPICLONE, LUNESTA, SONATA, ZALEPLON, INTERMEZZO, ZOLPIDEM, AMBIEN, EDLUAR, BELSOMRA, BUTISOL SODIUM, FLURAZEPAM, HETLIOZ, ROZEREM, DAYVIGO |
3 MB |
PDF File
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Eff. Date: 07/05/2022
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ARIKAYCE |
628 KB |
PDF File
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Eff. Date: 02/28/2023
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BUNAVAIL, BUPRENORPHINE, BUPRENORPHINE-NALOXON, SUBOXONE, ZUBSOLV |
1 MB |
PDF File
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Eff. Date: 10/20/2022
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CARISOPRODOL-ASPIRIN, CARISOPRODOL COMPOUND, CARISOPRODOL CPD-CODEINE, CARISOPRODOL, SOMA |
654 KB |
PDF File
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Eff. Date 12/01/2023
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NURTEC, UBRELVY, ZAVZPRET |
478 KB |
PDF File
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Eff. Date 05/18/2023
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AIMOVIG, AJOVY, EMGALITY, NURTEC, QULIPTA |
783 KB |
PDF File
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Eff. Date: 02/01/2023
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ARMODAFINIL, MODAFINIL, NUVIGIL, PROVIGIL, SUNOSI, WAKIX |
1 MB |
PDF File
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Eff. Date: 10/22/2012
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|
22 KB |
PDF File
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Eff. Date: 02/28/2023
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ALA-HIST, ALLFEN DM TAB, AP-HIST DM LIQ, APRODINE TAB, BENZONATATE, BROMFED DM CGH SYR, BROMPHENIR-PSEUDO-DM SYR, BROTAPP, CHEST CONG RELIEF, CHLD DELSYM, CHLD COLD & CGH DM ELIXI, CHLD MUCINEX, CHLD DAYCLEAR ALL CGH, CHLO TUSS LIQ, CGH DM, CGH SYR, DALLERGY, DECONEX DMX TAB, DECONEX IR TAB, DELSYM, DEXTROMETHORPHAN ER, DIMAPHEN, ED A-HIST, ED BRON GP LIQ, ED CHLORPED D PEDIATRIC DROPS, ENDACOF-DM LIQ, EX ACTION CGH SYR, GUAIFEN, GUAIFEN ER, GUAIFEN/PSE, HISTEX, IOPHEN, KIDKARE CGH & COLD LIQ, KID'S MUCINEX MINI-MELTS PACK, LODRANE D CAPSULE, LOHIST, LORTUSS, MAXIPHEN, M-END DMX LIQ, M-HIST DM LIQ, MUCINEX, MUCUS RELIEF, NASAL DECON SPRAY, NASOPEN PE LIQ, NIGHT CGH LIQ, NINJACOF LIQ, NOHIST, NOSE DROPS, ORGAN-I, PED CGH-COLD LIQ, PHENYLEPHRINE-PYRILAMINE, POLY HIST, POLY-VENT, POLYTUSSIN, PROMETHAZINE, Q-TUSS, RESCON, RESPAIRE-30, ROBAFEN, RU-HIST D, RYMED, SILTUSS, SINUS RELIEF 1% NASAL SPRAY, SM NASAL SPRAY, SM TUSS DM, STAHIST AD, SUDOGEST SINUS & ALLERGY, TUSS, VANACOF, VANATAB |
1 MB |
PDF File
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Eff. Date: 09/13/2023
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KALYDECO, ORKAMBI, SYMDEKO, TRIKAFTA |
2 MB |
PDF File
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Eff. Date: 12/01/2023
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ACTEMRA, AMJEVITA, ARCALYST, CIBINQO, CIMZIA, COSENTYX, ENBREL, ENSPRYNG, HUMIRA, ILARIS, ILUMYA, KEVZARA, KINERET, LITFULO, OLUMIANT, ORENCIA, OTEZLA, RINVOQ, SILIQ, SIMPONI, SKYRIZI, SOTYKTU, STELARA, TALTZ, TREMFYA, XELJANZ |
2 MB |
PDF File
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Eff. Date: 07/21/2023
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DAYBUE |
783 KB |
PDF File
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Eff. Date: 04/07/2023
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DDAVP, DESMOPRESSIN ACETATE |
358 KB |
PDF File
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Eff. Date: 10/06/2023
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ALA-HIST DM LIQ, AP-HIST DM LIQ, ALLFEN DM TAB, BROMFED DM CGH, BROMPHENIR-PSEUDO-DM SYR, BROTAPP DM LIQ, CHILD DELSYM, CHILD C&C DM ELIX, CHILD MUCINEX, DECONEX DMX TAB, DELSYM 30MG/5ML SUSP, DELSYM CGH+CHEST CNGST DM LQ, DEXTROMETHORPHAN ER 30MG/5ML, DIMAPHEN DM ELIX, ED-A-HIST DM LIQ, ED-A-HIST DM TAB, ENDACOF-DM LIQ, EXT ACTION CGH SYR, GUIAFEN-DM ER 1,200-60MG TAB, HISTEX-DM SYR, IOPHEN DM-NR LIQ, KIDKARE C&C LIQ, LOHIST-DM SYR, LORTUSS DM LIQ, M-END DMX LIQ, M-HIST DM, MAXIPHEN DM TAB, MUCINEX CGH MINI-MELT PACK, MUCINEX DM ER 600-30MG TAB, MUCINEX DM ER 1,200-60MG TAB, MUCINEX FAST-MAX CONG-CGH, MUCINEX FAST-MAX DM MAX LIQ, NOHIST-DM LIQ, PED C&C LIQ, POLY-HIST DM LIQ, POLY-VENT DM TAB, POLYTUSSUN DM, PROMETH-DM SYR, Q-TUSS DM SYR, RESCON-DM LIQ, ROBAFEN CF LIQ, ROBAFEN-DM, ROBAFEN CGH 15MG LIQGEL, ROBAFEN DM CGH-CHEST CONG SYR, RYNEX DM LIQ, SILTUSS DM CGH SYR, SILTUSS DM DAS LIQ, SM TUSS DM, TUSS DM, VANACOF DM LIQ, VANACOF DMX, VANATAB DM CAP, VIRDEC DM DRP |
432 KB |
PDF File
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Eff. Date: 10/20/2022
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DICLOFENAC GEL 3%, DICLOFENAC SOL 1.5%, PENNSAID SOL 2% |
922 KB |
PDF File
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Eff. Date: 10/18/2022
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APOKYN, KYNMOBI |
597 KB |
PDF File
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Eff. Date: 10/29/2019
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BONJESTA ER, DICLEGIS DR |
254 KB |
PDF File
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Eff. Date: 03/27/2019
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ALOGLIPTIN, ALOGLIPTIN-METFORMIN, ALOGLIPTIN-PIOGLIT, GLYXAMBI, JANUMET, JANUMET XR, JANUVIA , JENTADUETO, JENTADUETO XR , KAZANO, KOMBIGLYZE XR , NESINA, ONGLYZA , OSENI , QTERN , STEGLUJAN, TRADJENTA |
314 KB |
PDF File
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Eff. Date: 10/07/2021
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EMFLAZA |
753 KB |
PDF File
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Eff. Date: 10/18/2022
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ALDURAZYME, CEPROTIN, ELAPRASE, FABRAZYME, GALAFOLD, NAGLAZYME, NITYR, ORFADIN, REVCOVI, STRENSIQ, VIMIZIM |
1 MB |
PDF File
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Eff. Date: 04/28/2023
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ARANESP, EPOGEN, MIRCERA, PROCRIT, REBLOZYL, RETACRIT |
1 MB |
PDF File
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Eff. DAte: 06/09/2022
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EVRYSDI |
793 KB |
PDF File
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Eff. Date: 03/21/2023
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ACTIQ, FENTANYL, FENTORA |
3 MB |
PDF File
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Eff. Date: 10/13/2023
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FILSPARI |
941 KB |
PDF File
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Eff. Date: 07/26/2023
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VOWST |
723 KB |
PDF File
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Eff. Date: 04/28/2023
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GATTEX |
632 KB |
PDF File
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Eff. Date: 10/10/2023
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AMITIZA, IBSRELA, LINZESS, ALOSETRON HCL, LOTRONEX, MOVANTIK, MOTEGRITY, RELISTOR, SYMPROIC, TRULANCE, VIBERZI |
2 MB |
PDF File
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Eff. Date: 08/09/2023
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BYDUREON, BYETTA, MOUNJARO, OZEMPIC, RYBELSUS, SOLIQUA, TRULICITY, VICTOZA, XULTOPHY |
794 KB |
PDF File
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Eff. Date: 09/12/2022
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MYFEMBREE, ORIAHNN |
922 KB |
PDF File
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Eff. Date: 07/21/2023
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GENOTROPIN, HUMATROPE, NORDITROPIN NORDIFLEX, NORDITROPIN FLEXPRO, NUTROPIN AQ, OMNITROPE, SAIZEN, SEROSTIM, SKYTROFA, SOGROYA, ZORBTIVE |
2 MB |
PDF File
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Eff. Date: 03/23/2023
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BERINERT, CINRYZE, FIRAZYR, HAEGARDA, KALBITOR, RUCONEST, TAKHZYRO |
705 KB |
PDF File
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Eff. Date: 12/02/2022
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HP ACTHAR GEL |
769 KB |
PDF File
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Eff. Date: 10/07/2021
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JUXTAPID, PRALUENT, REPATHA |
1 MB |
PDF File
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Eff. Date: 03/30/2023
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BYLVAY, LIVMARLI |
743 KB |
PDF File
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Eff. Date: 11/13/2023
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IMCIVREE |
781 KB |
PDF File
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Eff. Date: 10/19/2022
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ALDARA, IMIQUIMOD, ZYCLARA |
736 KB |
PDF File
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Eff. Date: 10/19/2022
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INCRELEX |
969 KB |
PDF File
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Eff. Date: 10/28/2022
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BETHKIS, CAYSTON, KITABIS PAK , TOBI, TOBRAMYCIN |
632 KB |
PDF File
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Eff. Date: 09/13/2023
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KETOROLAC |
1 MB |
PDF File
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Eff. Date: 10/28/2022
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KEVEYIS |
777 KB |
PDF File
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Eff. Date: 01/17/2023
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LIDOCAINE, LIDODERM, ZTLIDO |
750 KB |
PDF File
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Eff. Date: 10/22/2021
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BENLYSTA, LUPKYNIS |
993 KB |
PDF File
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Eff. Date: 09/01/2023
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LYRICA, LYRICA CR, PREGABALIN, PREGABALIN ER |
223 KB |
PDF File
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Eff. Date: 03/23/2023
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ADBRY, DUPIXENT, FASENRA, NUCALA, XOLAIR |
2 MB |
PDF File
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Eff. Date: 06/01/2023
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AMPYRA, AUBAGIO, DALFAMPRIDINE, MAVENCLAD, MAYZENT, PONVORY, TASCENSO ODT, TERIFLUNOMIDE, ZEPOSIA |
1 MB |
PDF File
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Eff. Date: 10/28/2022
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GABAPENTIN, GRALISE, HORIZANT, NEURONTIN |
2 MB |
PDF File
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Eff. Date: 05/24/2022
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NITAZOXANIDE |
678 KB |
PDF File
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Eff. Date: 03/29/2019
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NUPLAZID |
419 KB |
PDF File
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Eff. Date: 09/13/2023
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ICOSAPENT ETHYL, LOVAZA, VASCEPA |
889 KB |
PDF File
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Eff. Date: 04/28/2022
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EYSUVIS, RESTASIS MULTIDOSE, RESTASIS EYE EMULSION, TYRVAYA, XIIDRA |
601 KB |
PDF File
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Eff. Date: 12/15/2022
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APAP-CAFF-DIHYDROCOD, APAP-COD, ACTIQ, APADAZ, ASCOMP/COD, BELBUCA, BELLADONNA-OPIUM, BUPRENORPHINE, BUTALB-APAP-CAFF-COD, BUTALB-CAFF-APAP-COD, BUTALBITAL COMP-COD, BUTORPHANOL, BUTRANS, CARISOPRODOL CPD-COD, COD-GUAIFEN, COD SULFATE, DEMEROL, DILAUDID, DOLOPHINE HCL, DSUVIA, DURAGESIC, DVORAH, EMBEDA ER, ENDOCET, FENTANYL, FENTORA, FIORINAL-COD, GUAIFEN-COD , GUAIATUSSIN AC, HYDROCODON-APAP, HYDROCODONE BT-IBU, HYDROCODONE-CHLORPHEN ER, HYDROCOD-HOMATROPINE, HYDROCODONE BT-IBU, HYDROCODONE-IBU , HYDROMET, HYDROMORPHONE, HYDROMORPHONE ER, HYSINGLA ER, KADIAN ER, LAZANDA NASAL SPRAY, LEVORPHANOL, LORCET, MEPERIDINE, METHADONE, METHADOSE, MORPHABOND ER, MORPHINE, MS CONTIN, NALBUPHINE, NALOCET, NINJACOF-XG, NORCO, NUCYNTA, NUCYNTA ER, OPIUM, OXYCODONE, OXYCODONE-APAP, OXYCODONE-ASA , OXYCODONE-IBU, OXYCONTIN, OXYMORPHONE HCL, OXYMORPHONE HCL ER, PENTAZOCINE-NALOXONE, PERCOCET, PROMET-COD, ROXICODONE, SUBSYS SPRAY, TRAMADO, TYLENOL COD, ULTRACET, ULTRAM, VICODIN, VIRTUSSIN, XTAMPZA ER |
1 MB |
PDF File
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Eff. Date: 3/29/2019
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ORILISSA |
403 KB |
PDF File
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Eff. Date: 12/02/2022
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OXERVATE |
679 KB |
PDF File
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Eff. Date: 03/22/2023
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OXYCONTIN, OXYCODONE HCL ER, XTAMPZA ER |
2 MB |
PDF File
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Eff. Date: 05/15/2023
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ADCIRCA, REVATIO, SILDENAFIL, TADALAFIL, TADLIQ |
685 KB |
PDF File
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Eff. Date:02/01/2023
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AURYXIA, CALCIUM ACETATE, CALPHRON, FOSRENOL, LANTHANUM CARB, PHOSLYRA SOL, RENAGEL, RENVELA, SEVELAMAR, VELPHORO |
814 KB |
PDF File
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Eff. Date: 10/19/2022
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PHENADOZ, PHENERGAN, PROMETHAZINE, PROMETHEGAN |
550 KB |
PDF File
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Eff. Date: 10/31/2022
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PROPYLTHIOURACIL |
794 KB |
PDF File
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Eff. Date: 06/26/2023
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ADEMPAS, LETAIRIS, OPSUMIT, ORENITRAM ER, TRACLEER, TYVASO, UPTRAVI, VENTAVIS |
226 KB |
PDF File
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Eff. Date: 01/24/2022
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PULMOZYME |
590 KB |
PDF File
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Eff. Date: 10/31/2022
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RANEXA |
784 KB |
PDF File
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Eff. Date: 04/22/2022
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RECORLEV |
849 KB |
PDF File
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Eff. Date: 10/22/2022
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VIVJOA |
783 KB |
PDF File
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Eff. Date: 10/13/2023
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REZUROCK |
639 KB |
PDF File
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Eff. Date: 03/29/2019
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SAVELLA |
669 KB |
PDF File
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Eff. Date: 09/12/2023
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FARXIGA, INPEFA, INVOKANA, JARDIANCE, STEGLATRO, INVOKAMET, SEGLUROMET, SYNJARDY, SYNJARDY XR, XIGDUO XR |
818 KB |
PDF File
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Eff. Date: 10/19/2022
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OXBRYTA |
741 KB |
PDF File
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Eff. Date: 10/13/2023
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SKYCLARYS |
657 KB |
PDF File
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Eff. Date: 03/29/2019
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SYMLIN, SYMLINPEN |
250 KB |
PDF File
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Eff. 11/01/2023
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SYNAGIS 50 MG/0.5 ML VIAL, SYNAGIS 100 MG/1 ML VIAL |
857 KB |
PDF File
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Eff. Date: 11/11/2020
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ACTOPLUS MET, ACTOPLUS MET XR, PIOGLITAZONE-METFORMIN, ACTOS, DUETACT, PIOGLITAZONE HCL, PIOGLITAZONE-GLIMEPIRIDE, AVANDIA |
977 KB |
PDF File
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Eff. Date: 12/01/2023
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AMZEEQ FOAM, BENSAL HP OINTMENT, BENZEFOAM, CLINDAMYCIN FOAM, ERY/BENZOYL GEL, FINACEA FOAM, FINACEA GEL, METRONIDAZOLE LOTION |
215 KB |
PDF File
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Eff. Date: 10/22/2021
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CICLOPIROX SOL, JUBLIA SOL, KERYDIN SOL, TAVABOROLE SOL |
930 KB |
PDF File
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Eff. Date: 09/01/2023
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ELIDEL, EUCRISA, OPZELURA, PROTOPIC, TACROLIMUS |
733 KB |
PDF File
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Eff. Date: 04/01/2022
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ADAPALENE, ADAPALENE-BENZYL PEROX, AKIEF, ALTRENO LOTION, ARAZLO, ATRALIN, AVITA, CLINDA-TRETINOIN, DIFFERIN, EPIDUO, EPIDUO FORTE, FABIOR, TAZAROTENE, TAZORAC, TRETINOIN, TRETINOIN GEL MICRO, ZIANA GEL |
414 KB |
PDF File
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Eff. Date: 10/08/2021
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TEGSEDI, VYNDAMAX, VYNDAQEL |
738 KB |
PDF File
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Eff. Date: 07/07/2023
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BUPHENYL, CARBAGLU, OLPRUVA, RAVICTI, SODIUM PHENYLBUTYRATE |
579 KB |
PDF File
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Eff. Date: 08/14/2023
|
VEOZAH |
797 KB |
PDF File
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Eff. Date: 10/13/2023
|
AUSTEDO, INGREZZA, TETRABENAZINE, XENAZINE |
2 MB |
PDF File
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Eff. Date: 04/22/2022
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VOXZOGO |
625 KB |
PDF File
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Eff. Date: 03/29/2019
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XIFAXAN |
288 KB |
PDF File
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Eff. Date: 10/08/2021
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XYREM, XYWAV |
670 KB |
PDF File
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Eff. Date: 01/20/2023
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ZTALMY |
667 KB |
PDF File
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Eff. Date: 02/07/2023
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ZYFLO |
225 KB |